Tag: Bloat

Low FODMAP on a budget – how to make the diet more affordable

One factor I have noticed about this diet is the likely increase in food costs, it is not possible to get gluten/wheat free foods on prescription in the UK. Free from food is expensive, no-one will disagree, so how can we make the Low FODMAP diet cheaper to follow?

Some of the vegetables and fruit allowed are not staple items, this also applies to the basic carbohydrates that are good to consider. It is important to have the full range of Low FODMAP foods to ensure you are receiving the full nutritional content in your diet your body needs to be healthy. But rising food costs are a problem currently, so help is required when you have been informed by your dietitian to try the diet to alleviate your IBS symptoms. So when shopping yesterday morning I thought about what to do to make the diet cheaper – here are some tips that might help:

1. Choose to buy in bulk, particularly the basic carbohydrates such as potatoes and rice.

2. If you have an ethnic supermarket close to where you live check out their prices for rice, they often have very large sacks of rice that are cheaper in bulk. This can mean a cost of £1.00-£1.20 a kilo – significant savings. Also check out bulk spice prices, again the saving can be substantial comparing with prices at the usual supermarket stocks. Some

supermarkets also are now providing bulk buy opportunities for rice.

3. Choose value items when buying fruit & vegetables, also some of the lower cost brand supermarkets such as Lidl and Aldi can have occasional offers of half price fruit & vegetables so watch out for these.

4. Remember misshapen fruit & vegetables taste the same and have the same level of nutrition and may be cheaper to buy.

http://www.telegraph.co.uk/earth/agriculture/farming/9572730/Wonky-fruit-and-veg-to-return-to-supermarket-shelves.html

5. Check out the offer shelves for items that are due to go out of date – it is normally obvious if fruit & vegetables are spoilt – check them thoroughly. You can make some real savings here.

6. Again check out for offers on free from items, they do occur and it is worth the outlay in time to watch for offers.

7. Base your diet on more cheaper carbohydrate basic foods, such as potatoes and make your own treats, this again may be cheaper than purchasing free from items.

8. Use your own flour blends, check out what is in ready-made wheat free flour blends and make your own this can also be better as some gluten-free blends do not always contain starches that are low FODMAP.

9. Utilise coupons, supermarket offers and trials of free from food items.

10 Plan your food for the week and shop accordingly.

11. Use as many UK basic food items in your diet as you can such as bananas, carrots, potatoes, oranges, lettuce, tomato (watch amounts if you are fructose intolerant,) cucumber, celery (1/4 stick maximum at any one meal.)  Also base your breakfast on cheaper own branded cereals – you can always add your own Low FODMAP dried fruit (a tablespoon or 13 g only) and nuts if you wish to.

12. If you do purchase wheat free bread, buy sliced, or slice it yourself and freeze what you don’t immediately need. This prevents wastage, also freeze other items you might not use initially. If you have a problem with resistant starches you might not want to freeze your bread – as freezing it can increase resistant starch content.

13. Utilise frozen and tinned fruit & vegetables, however be aware of what the tinned fruit juice is based on – you may be inadvertently adding a FODMAP to your diet, some have apple juice as a base.

14. Please don’t use ‘free from’ cook in sauces – these are generally not a great deal different from normal sauces, they may also contain onion and garlic. Make your own thickened with cornflour. Cornflour is simple to use to thicken sauces and it mixes into the sauce really easily.

15. Learn about your diet and look around the supermarket – the more expensive items will be on the free from shelves – alternatives may be available in other sections of the store.

16 If ordering on-line check out the delivery costs, purchase savvy to save on delivery costs.

17. Bulk cook recipes and freeze what you don’t eat.

18. Also make your own stock, when buying meat or chicken, cook the waste scraps and bones in water with a  carrot and herbs, allow to cool, skim off the fat and freeze in small amounts. Water from cooking vegetables can also be used in the same way if a vegetable stock is required.

19. Share bulk items with friends and family to share the initial cost in purchasing – using the principles of the co-operative society, originating in Rochdale and still a good ideal to follow when money is tight!

20. Even if it means that you don’t start the diet immediately, plan well, planning may be the key to ultimate success and a feeling of achievement when you can do the diet within budget.

Updated Jan 2015

 

Jules_GastroRD11 Comments

Fast eating – speedy way to make your IBS worse, the benefits of slow eating.

Why is it suggested to help IBS you need to ensure you relax, take time over your meals and chew food slowly? How does this advice help with reducing symptoms?

If you don’t chew your food well you are more likely to swallow air with your food, this can pass into the intestines and increase bloating. After your mouth your digestive system does not have teeth, your gut moves and squeezes to mix and push food through it, but this not break down tougher foods – you need to chew these foods well, prior to swallowing.

If you are eating whilst working you may experience stress, particularly if you are answering a discourteous email that demands some diplomacy in its response, or dealing with a complaint on the telephone. It does not help your digestion (or your IBS) if your body is experiencing stress whilst you are eating a meal. Stress causes an increase in adrenaline, a hormone that gets the body ready for action, and this hormone slows the digestive tract, slowing down digestion. Adrenaline reduces the amount of digestive juices that are secreted to help digest your food, therefore it is perhaps not surprising that you feel so uncomfortable if consuming food when stressed. Sitting up straight can also help – use gravity to help your digestion and don’t slouch when eating.

Sometimes it is difficult to change what we do, particularly if you feel that you may be penalised in some way if you take a break at work, but it is worth considering. Under the current economic climate it is difficult to insist on taking breaks if your colleagues do not, so perhaps it is time we all support each other and take back our work breaks and lunchtime, to allow everyone time to sit down, relax and ‘rest & digest.’

Jules_GastroRD2 Comments

Surely these digestive enzymes I’ve found can help – or are they money down the toilet?

You may be aware of ‘digestive’ enzymes and if you are currently in ‘gut hell’ you might have considered these of use. This post will give you the facts about digestive enzymes and whether they are of real benefit to everyone – or just those with a real clinical need!

I apologise now, but we have to discuss the business of stools (poo,) so if you are not happy with this I suggest you choose some of my other posts to read! Our bodies are generally very effective at producing enzymes, substances in our gut, which help break down the food we eat and allow it to pass into our bodies. Sometimes these do not work as effectively, or our bodies start to produce less, or we may have a genetic (family) link, which means our bodies don’t produce the enzyme at all (as with some Lactose Intolerance.)

You may have noticed that food passes right through your digestive tract and looks very similar when it comes out – to when it went in, this can be a bit shocking! Typical examples are sweetcorn. You may feel that digestive enzymes are therefore needed to help to break down the food you have eaten so you can utilize the nutrition it contains. Recognizable food in stools can suggest that you are not chewing your food well enough – your digestive tract mixes food, but past your mouth it does not have teeth!! So ensure you chew each mouthful well, this may reduce symptoms of bloating & pain and helps your body to get all the nutrients from the food you eat.

The picture ‘The Bristol Stool Chart‘ helps you identify the types of stool your body produces to help you to modify your diet to keep your gut healthy. 6927778-3x4-700x933Now ☺️ do you look in the toilet pan? Or are you a bit squeamish about matters below 😲 ? Not looking is NOT an option, how do you know that you are leaving the lav in a clean condition for the next user, if you flush and run? Going to the loo is a natural part of life, and for your health, you need to look – so get over it! The chart is about consistency, type 1-3 and you are constipated, check out post on fibre, type 4 is normal and type 5-7 means you have diarrhoea. This chart will be discussed in more detail in future posts.

So, have you heard also that digestive enzymes can help reduce the dreaded bloating that sometimes occurs? Who have you heard that from, producers of digestive enzyme ‘health’ supplements? Have you asked them how they know that the supplements they make are effective? – Do they put them through rigorous randomised controlled trials? Probably not.

We need to discuss digestive enzymes in two distinct areas – lactose and fructose intolerance and FODMAPs are a specific case and will be dealt with separately. But, how effective are ‘mixed’ digestive enzymes? Well, medications recommended by doctors are very effective, and if you doctor has prescribed pancreatic enzymes (containing lipase, amylase, proteases) to help with a medical condition, then you need to take them. If your body is producing ‘floaty’ greasy stools and you need to flush the loo more than once and they don’t go away, or your stools are very pale, like the colour of clay, then I would advise a trip to the doctors to get this investigated further. However mid brown stools are normal and should not require any ‘over the counter’ digestive enzymes to help your digestion. Diarrhoea means that your food is moving too quickly through your body, this may mean that you don’t get the full benefit of food, however this needs treating by a doctor, to resolve the situation – they may advise you see a dietitian. Any blood in stools, or black coloured stools (when not taking iron supplements) needs a trip to the doctors, with some urgency! Health food supplements containing mixed ‘digestive enzymes’ are generally not that effective, as the doses they contain are not adequate to be of any real use, and some ‘health food’ brands do not even state how much enzymes are in their product – positive obfuscation! How unhelpful :-(. I wouldn’t waste your money on these supplements, all they are good for is reducing your bank balance. Your doctor will prescribe you pancreatic enzymes should they be necessary.

Some food we eat never gets digested and these are generally starches that form part of the fibre in our diet. Our bodies do not produce the type of enzymes to help their digestion, examples are Fructo-oligosaccharides, sugar alcohols, Galacto-oligosaccharides. Sometimes they can be problematic if you are prone to bloating (See FODMAPs link below.) Since writing this post links to a website producing Fructosin a supplement that is suggested to help with fructose malabsorption has been removed and the company website has no reference to this supplement, so I can only assume they no longer supply this product. I will keep looking for this and post again if their is an update.

For galacto-oligosaccharides a product called Beano has been available for some time, but not widely in the UK, this may be worth considering but again efficacy may not be guaranteed for all. You need to check the labels of these products for other FODMAPs, such as polyols (sorbitol, mannitol, xylitol) – no enzyme helps with polyol digestion unfortunately.

Lactose intolerance is a condition where the body does not produce enough of the enzyme lactase to digest lactose (a sugar found in milk,) it can be as a result of a genetic family link and sometimes can occur after gut infections or as a result of coeliac disease (this usually resolves on following a strict gluten-free diet.) Lactose then ferments in the gut leading to lots of bloating and diarrhoea. The amount of lactose that is tolerated varies and lactase supplements are suggested to be helpful. The reference below is a very good piece of work on the effectiveness of lactase supplements, they need to be taken with the food and the study suggests that they are not that effective in manufacturers recommended doses, enteric coated* tablets are better. This is only true for the supplements that were tested, but it is worth a read. Other recent studies suggest that they might be of benefit, again we have an example of medical dichotomy so how do we resolve it? Looking at the harm of products might help, do lactase supplements cause harm? Probably not in doses advised for most people, therefore if you wish to try them as long as you are happy to buy them with the possibility that they may not work, I don’t have a problem with it! However if you suffer from galactosaemia you should avoid using enzymes to help milk digestion see the link below for more information. We are always questioning the efficacy of treatments by undertaking studies and new advice is always welcome, it is not that the medical community are always changing their minds without good cause.

http://www.patient.co.uk/doctor/Galactosaemia.htm

* allows supplement to pass through your stomach unchanged to where it’s needed, – your small intestine.

O’Connell, S., Walsh, G., (2005) Physicochemical Characteristics of Commercial Lactases Relevant to Their Application in the Alleviation of Lactose Intolerance Applied Biochemistry and Biotechnology Vol. 134, 2006 (revised)

Post updated May 2016

Jules_GastroRD5 Comments